Provider Demographics
NPI:1669503041
Name:MCGARTY, MAUREEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:
Last Name:MCGARTY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 NORTH MILLEDGE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30601-5807
Mailing Address - Country:US
Mailing Address - Phone:706-549-8518
Mailing Address - Fax:
Practice Address - Street 1:489 N MILLEDGE AVE STE B
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-3807
Practice Address - Country:US
Practice Address - Phone:706-548-8518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001230103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA68BBCHMMedicare ID - Type Unspecified